Overview

The SNOMED CT Implementation Maturity Framework (IMF) is designed to support a multi-stakeholder ecosystem, recognizing that successful implementation of SNOMED CT depends on coordinated efforts across national bodies, healthcare providers, and technology vendors.

The framework defines three primary stakeholder groups, each with distinct roles, responsibilities, and maturity assessment perspectives:

• Members (National Release Centers)

• User Organizations (software consumers)

• Vendors (software providers)

While all stakeholders are assessed across the same domains and maturity levels, the focus of assessment differs depending on the stakeholder type.

The IMF reflects a connected ecosystem model, where each stakeholder group depends on the others:

• Members provide governance, standards, and infrastructure

• Vendors develop products that implement those standards

• User Organizations deploy and use those products in real-world care settings

This relationship can be summarized as:

Effective SNOMED CT implementation requires alignment across all three groups.

Members are typically national or regional organizations responsible for governance and stewardship of SNOMED CT within a country or jurisdiction.

Key Responsibilities

• Define national strategy and policy

• Manage SNOMED CT licensing and distribution

• Develop and maintain national extensions

• Support interoperability at a national level

Assessment Focus

Assessment focuses on national capabilities, including governance structures, infrastructure, and adoption across the healthcare system.

Role in the Ecosystem

Members enable the environment in which SNOMED CT can be adopted and used consistently across healthcare systems.

User Organizations include healthcare providers and other entities that use SNOMED CT in clinical and operational workflows.

Key Responsibilities

• Implement SNOMED CT within clinical systems

• Support structured clinical documentation

• Ensure consistent and accurate coding practices

Assessment Focus

Assessment focuses on organizational implementation, including system integration, clinical usage, and workforce capability.

Role in the Ecosystem

User Organizations deliver care and generate clinical data, realizing the practical value of SNOMED CT.

Vendors are organizations that develop and maintain software systems that enable SNOMED CT use, such as electronic health records (EHRs), terminology services, and interoperability platforms.

Key Responsibilities

• Integrate SNOMED CT into products and platforms

• Provide terminology services and tooling

• Support interoperability standards (e.g., FHIR)

Assessment Focus

While vendors are a key stakeholder group, the IMF assesses the maturity of individual products, platforms, or solutions, rather than the vendor organization as a whole.

This means that:

• Different products from the same vendor may have different maturity levels

• Assessment focuses on product capabilities, such as terminology integration, interoperability, and usability

• Results reflect the real-world functionality available to user organizations

Role in the Ecosystem

Vendors build the tools and infrastructure that make SNOMED CT usable and scalable across healthcare systems.

Although roles differ, all stakeholders share common responsibilities:

• Supporting semantic interoperability

• Ensuring high quality, structured clinical data

• Aligning with standards and best practices

Collaboration between stakeholders is essential to achieve end-to-end maturity.

Achieving higher levels of maturity requires active collaboration between stakeholders.

Examples include:

• Members working with vendors to define national requirements

• Vendors delivering product capabilities aligned with standards

• User organizations providing feedback to improve systems and policies

A lack of alignment between stakeholders can limit progress, even if individual components are mature in isolation.

Introduction

This page maps each requirement from the SNOMED CT EHR Requirements Guide to a corresponding maturity level in the Implementation Maturity Framework (IMF) for Software Products.

The EHR Requirements Guide defines what a SNOMED CT-enabled EHR system should be capable of across six areas: Edition, Language and Content; User Interface; Analytics and Reporting; Maintenance; Storage; and Interoperability. The IMF for Software Products assesses how comprehensively and effectively those capabilities have been implemented, on a scale from Level 0 (None) to Level 5 (Optimising).

By aligning these two resources, this page helps:

• Vendors understand which requirements are expected at each stage of maturity, and plan a progressive implementation roadmap.

• National Release Centers (NRCs) frame procurement requirements in terms of the maturity level they wish to mandate or target, rather than applying all requirements uniformly.

• Assessors using the IMF tool to verify that a vendor's declared maturity level is substantiated by the corresponding EHR requirements being met.

Each requirement below is labelled with the IMF maturity level at which it is expected. Requirements at lower levels are foundational; they should be in place before higher-level capabilities are pursued.

The SNOMED CT Implementation Maturity Levels for Members (National Release Centers), highlights how adoption evolves at a national or regional level. It shows the progression from no coordinated activity to a fully optimized ecosystem where SNOMED CT is widely implemented, governed, and leveraged for advanced use. The model emphasizes how Members can progressively strengthen governance frameworks, expand adoption across affiliates, align with national health strategies, and enable interoperability and secondary use to support data-driven healthcare at scale.

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What are Assessment Criteria?

Assessment Criteria are the detailed evaluation questions, statements, or checkpoints used to measure the maturity and effectiveness of a specific Key Process Area (KPA).

They define the standards, practices, or capabilities that must be evaluated in order to determine how well a process area is implemented, managed, and optimized.

Purpose of Assessment Criteria

Assessment Criteria help:

• Standardize the evaluation process

• Ensure consistency across assessments

• Capture measurable evidence

• Identify capability gaps and improvement opportunities

• Support objective maturity scoring

Each criterion is designed to assess a specific aspect of a KPA and contributes to the calculation of the overall KPA Maturity Index.

Assessment Criteria are typically presented as questions or measurable statements.

Each assessment criterion typically includes:

• Question

  • A clear evaluation question defining what is being assessed.

• Context

Examples include:

• Governance Structure, organizational oversight and accountability

• Strategic Alignment, alignment with healthcare priorities

• Affiliate Adoption, extent of SNOMED CT uptake

Each assessment criterion is evaluated using standardized ranking options that are closely aligned with the overall maturity model of the framework.

The ranking levels represent progressive stages of capability maturity, from limited or ad hoc implementation to optimized and continuously improving practices. This ensures consistency between individual assessment criteria, KPA Maturity Indexes, and the Overall Maturity Level.

The framework typically uses a maturity scale such as:

• 0 - Not Implemented

• 1 - Initial / Ad Hoc

• 2 - Defined / Structured

• 3 - Advanced / Established

Each level is associated with a predefined score that contributes to maturity calculations across the framework.

This close alignment with the maturity model enables:

• Consistent and objective evaluation

• Comparable scoring across KPAs

• Clear identification of maturity progression

• Structured roadmaps for continuous improvement

Higher maturity levels indicate stronger governance, broader adoption, improved interoperability, and more advanced operational capabilities.

Assessment Criteria act as the operational layer of the framework. They translate high-level KPAs into practical and measurable evaluation points.

The results collected from all criteria within a KPA are consolidated to generate a maturity score for that process area. These scores are then combined to determine the organization’s overall maturity level.

Well-designed assessment criteria ensure that the maturity assessment is:

• Objective

• Repeatable

• Measurable

• Transparent

Clear and comprehensive criteria improve the accuracy of the assessment and provide meaningful insights that support informed decision-making and continuous improvement initiatives.

Overview

An Implementation Maturity Framework provides a common language for understanding where an organisation or system stands in its adoption of SNOMED CT, and what it would take to move forward. By offering a structured way to assess current capability and plan improvement, the framework can be applied across a wide range of contexts; from national health policy to product development to procurement.

This page outlines the key situations in which an implementation maturity framework is most commonly useful.

UC1. National Implementation Planning

Why is this useful? National health authorities face the challenge of coordinating SNOMED CT adoption across many different organisations, systems, and regions - each at very different stages of readiness. Without a common way to assess and describe capability, it is difficult to identify where the real gaps are, justify investment decisions, or build a realistic roadmap. A maturity framework gives national bodies a structured, evidence-based foundation for these conversations.

Typical Applications

• Assess national readiness for SNOMED CT implementation

• Identify gaps in governance, infrastructure, and workforce capability

• Develop national roadmaps and policies

• Support funding and investment decisions

Example Scenario A national health authority performs a maturity assessment and discovers that governance is well established but technical infrastructure is significantly underdeveloped. This gives them a clear, defensible basis for prioritising investment in national terminology services and distribution mechanisms - and a way to communicate that priority to stakeholders and funders.

Why is this useful? Healthcare providers often know that improving SNOMED CT implementation is a goal, but struggle to translate that goal into actionable priorities. Clinical, technical, and operational teams may have very different views of what "good" looks like. A maturity framework surfaces those differences and helps organisations agree on where to focus effort - whether that is training clinicians, improving systems, or embedding structured data into everyday workflows.

Typical Applications

• Evaluate readiness of clinical systems and workflows

• Plan SNOMED CT integration into EHR systems

• Improve structured clinical documentation

Example Scenario A hospital uses a maturity assessment to discover that its IT systems are relatively capable, but actual clinical adoption and use of SNOMED CT in practice is low. Rather than investing further in infrastructure, the assessment points clearly to clinician training and workflow integration as the highest-value next steps.

Why is this useful? Software vendors often have strong capability in some areas while lagging in others. A maturity framework helps vendors identify those gaps objectively, align their product roadmap with the needs of customers and the broader interoperability landscape, and articulate their SNOMED CT capabilities clearly when competing in the market or responding to procurement requirements.

Typical Applications

• Assess SNOMED CT support within products

• Align product roadmap with interoperability standards

• Improve usability of terminology features

Example Scenario A vendor uses a maturity assessment to identify that while its technical integration is strong, its support for semantic interoperability and terminology services is underdeveloped. This provides a clear, structured rationale for where to focus the next phase of product investment.

Why is this useful? Progress is hard to judge in isolation. Organisations and countries benefit from understanding how their implementation compares with peers - not to rank or shame, but to identify where good practice already exists and learn from those who have solved similar problems. A shared assessment framework makes that comparison meaningful and actionable.

Typical Applications

• Benchmark maturity against comparable organisations or countries

• Identify leading practices

• Support international collaboration and knowledge sharing

Example Scenario A group of countries each conduct a maturity assessment using the same framework and share their results. The comparison reveals which approaches to terminology governance and infrastructure have worked well in similar contexts, enabling targeted knowledge transfer and better alignment of interoperability strategies.

Why is this useful? Without a clear baseline and an agreed destination, implementation roadmaps tend to be vague, over-ambitious, or difficult to prioritise. A maturity framework provides both: an honest assessment of where an organisation is today, and a structured picture of what more advanced implementation looks like. This makes it possible to set realistic goals, sequence activities sensibly, and allocate resources where they will have the most impact.

Typical Applications

• Define current baseline and target state

• Prioritise initiatives

• Sequence implementation activities

• Allocate resources effectively

Example Scenario An organisation uses a maturity assessment to establish a clear starting point and set a defined target for where it wants to be within a given timeframe. The framework helps them break the journey into concrete, sequenced steps rather than attempting to improve everything simultaneously.

Why is this useful? Implementation is not a one-time event. Systems evolve, staff change, and adoption patterns shift over time. Regular maturity assessments give organisations a consistent mechanism to check whether progress is being sustained, surface new gaps as they emerge, and adjust strategy accordingly - turning a point-in-time snapshot into an ongoing improvement cycle.

Typical Applications

• Track progress over time

• Measure the impact of implementation efforts

• Adjust strategies based on evidence

Example Scenario A healthcare system makes maturity assessment a regular annual practice. Over successive cycles, they are able to demonstrate concrete improvements in data quality and adoption, and to identify specific areas where expected progress has not materialised — giving them an evidence base for refining their training and governance programmes.

Why is this useful? Procurement processes for health IT systems often struggle to assess SNOMED CT capability rigorously. Vendors may describe their terminology support in vague or incomparable terms. A maturity framework gives procuring organisations a structured basis for specifying what they need, and for evaluating and comparing what vendors actually offer - reducing the risk of selecting a system that cannot meet interoperability requirements in practice.

Typical Applications

• Define SNOMED CT requirements in procurement specifications

• Evaluate and compare vendor capabilities

• Ensure alignment with interoperability goals

Example Scenario A healthcare organisation embeds maturity-based criteria into its procurement process, giving all bidders a clear and consistent standard to respond to. This makes evaluation more objective and reduces the risk of purchasing a system whose SNOMED CT support is superficial or incomplete.

Why is this useful? Policymakers and regulators need practical ways to set implementation expectations, monitor compliance, and target incentives. Without an objective measure of capability, policy tends to be binary and difficult to apply fairly across a diverse landscape. A maturity framework enables a more graduated, proportionate approach - one that rewards progress and gives organisations a clear path toward compliance.

Typical Applications

• Define national implementation standards and requirements

• Support compliance monitoring

• Design incentives and mandates

Example Scenario A national authority uses a maturity framework to define what different levels of compliance look like in practice, and to design a tiered incentive structure that rewards organisations for demonstrable progress - rather than treating compliance as an all-or-nothing threshold.

This section provides guidance for User Organizations (e.g., healthcare providers) on how to progress between maturity levels.

Progression typically involves moving from isolated clinical use cases to enterprise-wide integration and data-driven care.

• SNOMED CT used in isolated workflows • No governance or strategy • Limited training

• Establish ownership and governance • Define implementation goals • Expand to additional clinical areas • Provide basic training

→ Structured but limited organizational adoption

The IMF is designed to be applicable across the full range of organisations involved in SNOMED CT implementation, while remaining precise enough to produce meaningful, actionable assessments. To achieve this, the framework is structured around three core design principles: it differentiates between distinct types of stakeholder, it organises assessment around defined areas of capability, and it uses consistent criteria to evaluate maturity within each of those areas.

The diagram illustrates a hierarchical maturity assessment framework used to evaluate organizational or process maturity across multiple stakeholders and key process areas.

• Stakeholder Layer

This section provides guidance to support Vendors in progressing to higher levels of maturity in SNOMED CT-enabled products.

Progression typically involves moving from basic feature support to fully integrated, intelligent, and interoperable platforms.

Moving from Level 0–1 (None / Basic) to Level 2 (Emerging)

Typical Situation

• Limited or no SNOMED CT support • Basic functionality

Key Actions

• Introduce SNOMED CT into core product features • Enable basic coding and storage • Provide initial user interfaces

Outcome

→ Initial SNOMED CT capability in the product

Moving from Level 2 (Emerging) to Level 3 (Advanced)

Typical Situation

• SNOMED CT supported in some modules • Basic usability

Key Actions

• Expand coverage across modules • Improve usability (search, selection) • Introduce structured terminology processes

→ Consistent SNOMED CT functionality across the product

• Good coverage • Limited interoperability depth • Manual terminology processes

• Implement terminology lifecycle management • Strengthen interoperability (standards-based exchange) • Improve data consistency • Automate updates and versioning

→ Scalable, interoperable product architecture

• Strong platform capability • Limited advanced features

• Introduce advanced analytics and CDS • Optimize performance and usability • Enable innovation and new use cases • Continuously improve based on feedback

→ Intelligent, data-driven platform

• Strong product design • Robust terminology management • Standards-based interoperability • Continuous innovation

Background

The SNOMED CT Implementation Maturity Framework (IMF) is a structured model developed by SNOMED International to support the effective adoption, integration, and optimization of SNOMED CT within healthcare systems.

SNOMED CT is a comprehensive clinical terminology used globally to enable consistent representation of clinical information and support semantic interoperability across systems and organizations.

Implementing SNOMED CT is a complex, multi-dimensional process that extends beyond terminology access. It requires coordinated progress across governance, technical infrastructure, workforce capability, and real-world usage.

The IMF has been developed through ongoing collaboration and input from the SNOMED International Member Forum, ensuring that it reflects real-world implementation experience across a diverse range of countries and healthcare systems. This collaborative approach allows the framework to incorporate practical lessons learned, common challenges, and proven strategies from national and organizational implementations.

The framework also builds on established maturity model approaches, adopting a progressive, staged model of capability development. It draws on concepts from widely used frameworks such as:

• Capability Maturity Model Integration (CMMI)

• ISO/IEC 15504 (SPICE)

• Healthcare maturity models such as those developed by HIMSS

These models share a common principle: organizations evolve through defined stages of maturity, with each level representing increased capability, consistency, and value realization.

By applying this approach to SNOMED CT implementation, the IMF provides a standardized and repeatable method for assessing maturity, identifying gaps, and guiding continuous improvement.

The objective of this guide is to:

• Describe the structure and purpose of the SNOMED CT Implementation Maturity Framework

• Define the maturity domains and levels used to assess SNOMED CT implementation

• Provide detailed assessment criteria for different stakeholder groups (Members, User Organizations, and Vendors)

This guide provides a structured framework for assessing and improving the maturity of SNOMED CT implementation across the healthcare ecosystem.

It applies to SNOMED CT implementation at multiple levels, including national, regional, organizational, and product contexts, and supports all key stakeholder groups:

• Members (National Release Centers)

• User Organizations (healthcare providers and service organizations)

• Vendors / Software Products

The framework covers the full range of capabilities required for effective SNOMED CT implementation, including governance, adoption, interoperability, capability development, and data use.

It is intended to support:

• Assessment of current maturity

• Identification of gaps and improvement priorities

• Development of implementation roadmaps

• Monitoring of progress over time

This guide is intended for:

• National Release Centers and health authorities

• Healthcare organizations and providers implementing SNOMED CT

• Health IT vendors and system developers

This guide is subject to ongoing review. Feedback from the international community is encouraged to support continuous improvement of the SNOMED CT Implementation Maturity Framework and its practical application.

A mature EHR product that:

• Has broad SNOMED CT coverage across core clinical modules

• Provides good usability (search, selection, UI integration)

• Supports basic interoperability standards

The SNOMED CT Implementation Maturity Levels for Vendors and Software Products provides a structured view of how terminology capabilities evolve within digital health solutions. It outlines the progression from no support for SNOMED CT to fully optimized, intelligent platforms that leverage advanced analytics, interoperability, and AI-driven features. The model highlights how vendors can incrementally enhance product functionality, usability, and integration to better support healthcare organizations in delivering high quality, standardized, and data-driven care.

Purpose of Self-Assessment

The SNOMED CT Implementation Maturity Framework (IMF) can be used independently of the interactive assessment tool to support structured, collaborative evaluation of implementation maturity.

This approach is particularly useful for:

• Facilitated workshops

• Strategic planning sessions

• Cross-functional reviews

• Early-stage assessments prior to formal scoring

A manual self-assessment enables organizations to build a shared understanding of their current state, validate assumptions, and identify improvement priorities.

Conducting a self-assessment involves five key steps:

1. Preparation

2. Scoring Individual Questions

3. Calculating KPA Scores

4. Determining Domain and Overall Maturity

Each step is described below.

• Conduct assessments collaboratively rather than individually

• Document assumptions and rationale for each score

• Repeat assessments periodically (e.g., annually)

Manual self-assessment:

• May be subjective without supporting evidence

• Can vary depending on participant perspectives

• Does not automatically generate reports or benchmarking

What are Key Process Areas?

Key Process Areas (KPAs) are the major functional domains or capability areas used to evaluate the maturity and effectiveness of an organization, department, system, or process. Each KPA represents a critical area that contributes to overall organizational performance and maturity.

KPAs help structure the assessment framework into manageable and measurable components. Instead of evaluating an organization as a whole, the maturity assessment is divided into specific areas that can be independently analyzed, scored, and improved.

Depending on the assessment type, KPAs may vary across:

• Members (National Release Centers)

• User Organizations

• Vendors and Software Product Providers

Each KPA contains a collection of Assessment Criteria used to evaluate maturity within that domain.

The purpose of KPAs is to:

• Organize the assessment into logical capability domains

• Identify strengths and weaknesses within specific operational areas

• Enable targeted improvement initiatives

Each stakeholder have one or more KPAs associated with their responsibilities or operational scope. Every KPA contains a set of assessment criteria used to evaluate the maturity of that area.

The responses collected from these assessment criteria are aggregated into a KPA Maturity Index, which reflects the maturity level of that specific process area.

KPAs have been identified for each of the three stakeholder groups: Members (National Release Centers), User Organizations, and Software Products.

While some KPAs, such as Governance and Strategy, Interoperability, and Analytics and Decision Support, appear across multiple groups, the full set varies by stakeholder type. This reflects the different roles each group plays in the SNOMED CT ecosystem.

KPAs for Members (National Release Centers)

• Growth and Adoption

• Governance and Strategy

• Stakeholder Engagement

• National Extension Management

KPAs for User Organizations (hospitals, clinics, registries)

• Scope of SNOMED CT Implementation

• Governance and Strategy

• User Proficiency and Training

• Interoperability

KPAs for Software Products / Vendors

• Scope of SNOMED CT Implementation

• Terminology Provisioning and Maintenance

• Usability and Tool Support

• Interoperability

KPAs provide clarity and focus during the assessment process. By evaluating each area independently, organizations can:

• Prioritize improvement efforts

• Allocate resources effectively

• Track maturity progression over time

• Align operational capabilities with strategic objectives

Ultimately, KPAs serve as the foundation of the maturity assessment framework and enable a structured, evidence-based evaluation approach.

The SNOMED CT Implementation Maturity Framework Guide is a structured resource designed to help stakeholders understand and assess their progress in adopting and integrating SNOMED CT. It provides detailed explanations of maturity levels, Key Process Areas (KPAs), and assessment criteria tailored to different stakeholder groups. The guide supports consistent evaluation, facilitates discussion, and helps organizations identify opportunities to advance toward more mature, interoperable, and data-driven use of SNOMED CT.

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A national health authority with:

• Well-established governance and national strategy

• Strong central SNOMED CT capability (extension, policy, guidance)

• Limited uptake across healthcare providers

The Implementation Maturity Framework (IMF) provides a consistent yet flexible model for assessing how SNOMED CT is adopted and used across the healthcare ecosystem.

The general maturity levels provide a shared foundation for assessing SNOMED CT implementation and ensure consistency across the ecosystem. However, their application varies by stakeholder, reflecting different roles, responsibilities, and objectives.

• Members (National Release Centers) apply the maturity levels at a national or regional level, focusing on governance frameworks, policy alignment, infrastructure, and the breadth of adoption across affiliates and healthcare systems.

The SNOMED CT Implementation Maturity Framework (IMF) describes how organisations evolve in their use of SNOMED CT, from initial awareness and limited use to fully integrated, optimised, and data-driven implementation. This page provides general guidance on how maturity develops and how to progress to higher levels.

Maturity reflects how effectively SNOMED CT is implemented and used to support healthcare delivery, interoperability, and data-driven decision-making across the ecosystem. It is not only about whether SNOMED CT is present, but how well it is adopted across relevant areas, systems, or products; embedded into workflows, services, or functionality; governed through clear ownership, policies, and strategy; exchanged consistently across systems and organisations; and used to generate insight, support decisions, and improve outcomes.

At lower levels, SNOMED CT is typically used in isolated ways, often driven by specific projects or requirements. At higher levels, it becomes a core capability, enabling consistent, interoperable, and value-driven use of health information across the ecosystem.

Maturity develops progressively, moving from isolated use toward integrated and optimised use. While the exact path differs by stakeholder type, the overall pattern is consistent.

The SNOMED International Implementation Portal provides resources, guidance, and tools to support SNOMED CT adoption across all stakeholder groups.

• : Main portal for SNOMED CT implementation resources and services

• : Interactive tool for planning a SNOMED CT Implementation project

This SNOMED CT Implementation Maturity Levels for User Organizations (Healthcare Providers), shows how the use of SNOMED CT evolves within clinical and operational environments. It outlines the progression from no use of standardized terminology to fully integrated, data-driven organizations where SNOMED CT is embedded across workflows, systems, and decision-making processes. The model highlights how healthcare providers can progressively enhance governance, user adoption, interoperability, and data use to support improved care delivery, analytics, and continuous improvement.

This section guides Members (national or regional organizations) on how to progress between maturity levels.

Members often exhibit uneven maturity, with strong central capability but limited adoption across affiliates. Progression requires moving from central readiness to ecosystem-wide implementation.

Moving from Level 0–1 (None / Basic) to Level 2 (Emerging)

Typical Situation

• No formal governance

• Limited or no national strategy

• Minimal adoption

• Establish national governance structure

• Define roles and responsibilities

• Develop a national SNOMED CT strategy

• Provide access (licensing, distribution)

→ Structured national approach with initial adoption

• Governance exists • Early adopters present • Limited coordination

• Expand adoption across affiliates

• Provide implementation guidance

• Establish stakeholder engagement mechanisms

• Introduce monitoring and metrics

→ Growing and coordinated adoption across the ecosystem

• Broad but uneven adoption

• Infrastructure in place

• Limited standardization

• Standardize implementation nationally

• Strengthen interoperability frameworks

• Improve terminology services and extensions

• Align stakeholders and systems

→ Consistent, interoperable national ecosystem

• High adoption

• Strong infrastructure

• Limited advanced data use

• Enable advanced analytics and research

• Continuously improve governance and processes

• Support innovation and new use cases

• Monitor outcomes and impact

→ Fully optimized, data-driven national system

• Strong national leadership

• Active stakeholder engagement

• Clear policies and standards

• Continuous monitoring and improvement

Scenario

A regional hospital that:

• Uses SNOMED CT in several key departments (e.g., emergency, inpatient)

• Has invested in clinician training and support

• Has inconsistent workflow integration across systems

• Has limited interoperability with external partners

• Uses SNOMED CT minimally for analytics and decision support

This reflects a typical provider organization, where adoption is driven by local clinical needs rather than enterprise-wide strategy.

KPA Score = (25 + 25) ÷ 2 = 25

KPA Score = 25

KPA Score = 50

KPA Score = 25

KPA Score = 25

Domain Score = (25 + 25 + 50 + 25 + 25) ÷ 5 = 30

→ Level 1 – Basic (upper range)

• Emerging training programs and internal expertise

• Early clinical adoption in selected departments

• Growing awareness of SNOMED CT benefits

• Limited and inconsistent adoption across the organization

• Lack of formal governance and strategy

• Weak interoperability and standards alignment

To progress to Level 2–3, the organization should:

• Define roles and responsibilities

• Develop an implementation roadmap

• Align with organizational strategy

• Roll out SNOMED CT across more departments

• Standardize usage across systems

• Embed SNOMED CT in clinical documentation and processes

• Reduce reliance on free text

• Align with standards (e.g., FHIR)

• Improve data exchange with partners

• Use SNOMED CT for reporting and quality improvement

• Introduce basic dashboards and insights

This guide is designed as a manual resource to support reading, reflection, and structured discussion around SNOMED CT implementation maturity.

It provides:

• Detailed explanations of each Key Process Area (KPA)

• Full visibility of all questions, contexts, and answer options

• A shared reference for workshops, stakeholder discussions, and planning sessions

Organizations can use this document to:

• Facilitate internal reviews and group assessments

• Support strategic conversations across teams

• Build a common understanding of maturity levels and expectations

In addition to this guide, an interactive version of the assessment is available:

This online tool enables you to:

• Complete the assessment digitally

• Automatically calculate maturity scores

• Generate structured outputs and insights

• Track progress more efficiently

• Use this guide when you want:

  • A comprehensive reference

  • To support facilitated discussions or workshops

The guide and the interactive tool are designed to complement each other:

• The guide provides depth, context, and shared understanding

• The tool provides efficiency, scoring, and reporting

Using both together ensures a more robust, consistent, and meaningful assessment process.

This assessment is designed for User Organizations (e.g., healthcare providers, hospitals, government agencies) that implement SNOMED CT within their systems and workflows .

It enables organizations to evaluate:

• Clinical adoption and workflow integration

• Governance and strategic alignment

• User capability and training

• Interoperability readiness

• Use of analytics and decision support

The objective is to assess maturity, identify gaps, and guide continuous improvement in clinical terminology use.

This KPA evaluates how extensively SNOMED CT is implemented across clinical areas and embedded into workflows.

It focuses on:

• Breadth of adoption across departments and care settings

• Depth of integration into clinical processes

Higher maturity indicates enterprise-wide adoption with deep workflow integration, supporting consistent clinical documentation and care delivery.

This KPA assesses the organizational structures, policies, and strategic alignment guiding SNOMED CT implementation.

It focuses on:

• Governance frameworks

• Roles and accountability

• Strategic planning and alignment

Higher maturity reflects well-defined governance integrated into organizational and digital health strategies.

This KPA evaluates how well users are trained, supported, and empowered to use SNOMED CT effectively.

It focuses on:

• Training programs

• Knowledge dissemination

• Internal champions and expertise

Higher maturity indicates a knowledgeable workforce supported by structured training and expert networks.

This KPA measures the ability to exchange SNOMED CT-coded data across systems.

It focuses on:

• Data exchange capabilities

• Standards alignment

Higher maturity reflects seamless, standards-based interoperability across healthcare systems.

This KPA evaluates how SNOMED CT is used to support analytics, reporting, and clinical decision support.

It focuses on:

• Clinical analytics

• Reporting

• Decision support systems

Higher maturity reflects data-driven healthcare supported by predictive analytics and real-time clinical guidance.

This assessment is designed for Vendors and Software Product Providers that develop and deliver systems incorporating SNOMED CT (e.g., EHRs, clinical platforms, decision support tools) .

It enables evaluation of:

• Breadth of SNOMED CT implementation across products

• Terminology management capabilities